Dystrophic Breast Calcification

Radiographers commonly find breast calcifications on a mammogram, and dystrophic calcification is a certain type of calcification.

Specialists consider dystrophic calcification to be a benign (non-cancerous) finding. However, the most common situation to find dystrophic calcification is following breast cancer radiation treatments.

These calcifications will often show up on a followup investigation and are generally a welcome sign. They are also quite common following breast trauma, including surgery.

Most breast calcifications are caused by benign breast changes

Breast calcifications routinely appear on breast cancer screening mammograms.

Calcifications generally form from deposits of calcium salts in damaged or necrotic (dead) breast tissue. Breast calcifications are an important sign of changes in the breast and most will turn out to be benign.

However, some calcifications do turn out to be more worrisome. Calcifications and microcalcifications (that are smaller and usually found ‘earlier‘) are part of a breast cancer risk classification system called BI-RADS.

Indeed BI-RADS classifies the calcification according to various characteristics. Dystrophic calcification is one such classification, that roughly corresponds to a BI-RADS category of 2. But, be reassured, this is a benign finding and not indicative of cancer in any way.

Characteristics of Dystrophic Calcification of the breast

Dystrophic calcifications tend to be on the large side (greater than 0.5 mm) and are irregular in shape and course. They also tend to be quite dense and have lucent (shining/glossy) centers under the microscope.

A dystrophic calcification also tends to have smooth margins, unlike the irregular margins common in microcalcification suggestive of malignancy.

What does a finding of Dystrophic Calcification really mean?

If dystrophic breast calcification occurs on a screening mammogram, it most likely indicates some other benign condition besides cancer.

For women who have already had treatments for breast cancer, dystrophic breast calcifications are to be expected and suggest that everything is OK.

Dystrophic Calcification in breast tissue often remain stable for many years

Large dystrophic calcifications of the breast usually remain stable for many years and are typically not associated with any kind of palpable mass. Following a breast procedure, up to 30% of women may develop dystrophic breast calcifications for up to 4 years.

Breast Dystrophic Calcifications can return after Radiation Treatment

But, If dystrophic calcification return following breast reduction surgery or radiation therapy in a new position, this is a bit more concerning.

The BI-RADS (breast cancer risk) category may then go up to 3 or 4. These BI-RADS categories mean ‘probably benign‘ to ‘somewhat suspicious for malignancy’.

Other possible causes of Dystrophic Calcification in breast tissue

Indeed, paraffin or silicone injections from breast augmentation procedures can also cause dystrophic calcification of the breast.

Other conditions that can cause dystrophic calcification are dermatomyositis or as a secondary effect of hyperparathyroidism.

References

Jackson VP. (2004) Diagnostic Mammography. Radiol Clin North Am. 2004 Sep;42(5):853-70, vi. https://www.ncbi.nlm.nih.gov/pubmed/15337421
Meier-Meitinger M, Adamietz B, Schulz-Wendtland R. (2009) Ehlers-Danlos syndrome and bilateral, dystrophic breast calcifications. Radiologe. 2009 Sep;49(9):868-71. https://www.ncbi.nlm.nih.gov/pubmed/19148618
Picca D, de Parades ES. (2003) Calcifications in the breast: A radiologic perspective. Applied Radiology, Volume 32, Number 9, September 2003
Sickles EA. (1986) Breast Calcifications: Mammographic Evaluation Radiology; 160:289-293
Yi A, Kim HH, Shin HJ, Huh MO, Ahn SD, Seo BK. (2009) Radiation-Induced Complications after Breast Cancer Radiation Therapy: a Pictorial Review of Multimodality Imaging Findings. Korean J Radiol. 2009 Sep-Oct;10(5):496-507. https://www.ncbi.nlm.nih.gov/pubmed/19721835